?associated lesions (25%) and 0 cases in the group without the lesions. The finding of extracapsular low-signal-intensity lesions should therefore alert the radiologist to the possibility of aseptic lymphocytic vasculitis?? Either titanium or stainless steel. A, Coronal fast spin-echo (FSE) (A) and multiacquisition variable?? The area of synovitis or osteolysis was calculated on each slice; the sum of the areas across multiple slices was then multiplied by the slice thickness to obtain a volume measurement (Fig. It’s a pain enough (literally and figuratively) to get a hip replacement.You have to get diagnosed, receive a prognosis, schedule pre-surgery checkups, plan for your time away from work and … CONCLUSION. Synovitis was seen to decompress into adjacent bursae in 14 hips (58.3%): trochanteric bursa, 10 hips; iliopsoas bursa, three hips; and trochanteric and iliopsoas bursae, one hip. ?63.8 cm3). There was no difference in the proportion of patients with synovitis (p = 0.51) between the resurfacing arthroplasty and THA groups. The volume of synovitis did not correlate to sex (p = 0.08), age (r = 0.15, p = 0. Using the grading system proposed by Campbell et al. Fig. Ultimately, the hip replacement implant you end up with is selected by your surgeon depending on fit, your arthritic damage, activity level, weight, age, and other lifestyle factors. ?100 kHz; FOV, 18?? The MRI examinations of patients with metal-on-metal hip prostheses placed at resurfacing arthroplasty (n = 31) or THA (n = 29) were reviewed for osteolysis, synovitis, extracapsular disease, synovial pattern, and mode of decompression into adjacent bursae. Whether osteolysis was present and, if present, the location (acetabulum, femur, or both) were recorded. A score of 0?? This debris can trigger a response in your body, which can cause erosion of bone and loosening of the implants. Fig. D, 57-year-old man who presented for follow-up imaging 43 months after total hip arthroplasty. Data were collected about the demographic characteristics of patients including sex, age, and body mass index (BMI); type of implant used; and length of time since arthroplasty. Extracapsular disease was detected in two of the resurfacing arthroplasty hips (6.5%), with a mean volume of 36.6 ?? An additional prototype multiacquisition variable-resonance image combination (MAVRIC) scan designed to further reduce susceptibility artifact [12, 13] was acquired. Standard anteroposterior pelvic and lateral hip radiographs were evaluated by an experienced musculoskeletal radiologist who was blinded to the MRI findings. 256?? Edema was observed in four cases (gluteus medius, n = 1; gluteus medius and minimus, n = 1; iliopsoas, n = 2). ?6, 19]; however, the MRI appearance of aseptic lymphocytic vasculitis?? ?6; acquisition matrix, 512 (frequency) ?? A, 54-year-old woman who presented for follow-up imaging 16 months after resurfacing arthroplasty. All quantitative measurements were performed by one musculoskeletal radiologist. Before having an MRI scan, you should tell medical staff if: ... artificial joints – such as those used for a hip replacement … 2 ?? Muscle atrophy was observed in nine cases (gluteus medius, n = 2; gluteus minimus, n = 7). Hip Anatomic Variants That May Mimic Abnormalities at MRI: Labral Variants, Pictorial Essay. 20.4 cm3 (range, 1.5?? B, 42-year-old man who presented for follow-up imaging 31 months after resurfacing arthroplasty. Chi-square tests of association (2 ?? ?198.1 cm3). 1a) a CoCr hip-ball replacement and (Fig. ?384 (phase); and slice thickness, 3?? Manual segmentation was performed on a dedicated PACS workstation. The MRI examinations of patients with metal-on-metal hip prostheses placed at resurfacing arthroplasty (n= 31) or THA (n= 29) were reviewed for osteolysis, synovitis, extracapsular … All subjects underwent MRI using standard clinical protocols optimized to minimize metallic susceptibility artifact [14]. MRI Findings in Painful Metal-on-Metal Hip Arthroplasty, Patient Follow-Up and Histologic Analysis, Comparison of Resurfacing Arthroplasty Group and Total Hip Arthroplasty Group, Patient Demographics and Radiographic Assessment, Comparison of MRI, Operative, and Histologic Findings, aseptic lymphocytic vasculitis?? This method did not allow us to assess interobserver reliability; however, that assessment was not the aim of our study. ?4 mm [14]. 2). In all cases, extracapsular disease consisted of low-signal-intensity lesions dissecting into the hip abductor muscles (two cases) or obturator internus muscle (one case). The most common synovial pattern in patients with histologically confirmed aseptic lymphocytic vasculitis?? To enable Verizon Media and our partners to process your personal data select 'I agree', or select 'Manage settings' for more information and to manage your choices. All radiographic abnormalities were confirmed on MRI. 135.8 mm3) than the resurfacing arthroplasty group (31.3 ?? Imaging Key Wrist Ligaments: What the Surgeon Needs the Radiologist to Know, Original Research. MR image shows synovitis to decompress posterolaterally into trochanteric bursa (arrows). However, we found that tendinosis is extremely common after metal-on-metal hip arthroplasty, confirming the results of studies of conventional metal-on-polyethylene hip arthroplasty [21]. ?87.1% of patients with a metal-on-metal prosthesis [5, 6, 20]. Previous MRI studies have shown that periprosthetic soft-tissue masses or fluid collections may correlate to aseptic lymphocytic vasculitis?? Pseudotumors in association with well-functioning metal-on-metal hip prostheses: a case-control study using three-dimensional computed tomography and magnetic resonance imaging. Zimmer’s internal testing has revealed that although each metallic material exhibits a small but measurable magnetic attraction in the 1.5 Tesla and 3.0 Tesla environments, the maximum magnetic force exerted on a device (stainless steel… Reduction of susceptibility artifact was primarily achieved through the use of a wide receiver bandwidth, which increases the strength of the readout gradient. Fig. Osteolysis was detected in seven of the THA hips (24.1%), with a mean volume of 2.6 ?? In five of the 25 cases, synovitis was detected only on the MAVRIC images. ?129.7 cm3) and had a significantly (p = 0.02) higher rate of decompression of synovitis into adjacent bursae (83.3% vs 20.0%, respectively). Patients with a metal-on-metal prosthesis placed at resurfacing arthroplasty or THA who had been referred for MRI to investigate unexplained hip pain were included in this study. In half of the subjects, measurements were performed by a second musculoskeletal radiologist to allow assessment of interobserver reliability. Also note improved depiction of prosthesis-bone interface (white arrows, B) on MAVRIC image. My wife broke her hip two years ago and now has 3 stainless steel screws in it. In five of the 24 cases, synovitis was detected only on the MAVRIC images. Type 316L stainless steel is commonly used in surgical procedures to replace biological tissue or to help stabilize a biological structure, such as bone tissue to aid the healing process.Type 316L stainless steel is popular for surgical practices as it … Intramuscular edema was observed only in cases with aseptic lymphocytic vasculitis?? Paramagnetic materials have some attraction to magnetic fields, but if secured in position in the form of an implant, may be safe to use in standard MRI … ?associated lesions. ?100 kHz; FOV, 34?? ?60-year-old woman who presented for follow-up imaging 34 months after resurfacing arthroplasty. A Spearman rank correlation analysis was performed to calculate the correlation coefficient (r) between the volume of synovitis and demographic data for each group. MR image shows synovitis to decompress anteriorly into iliopsoas bursa (arrows). Tissue was routinely processed, cut, and stained with H and E. Histologic sections were examined at light microscopy without knowledge of the MRI classification. ?384 (phase); and slice thickness, 3?? The volume of synovitis did not correlate to sex (p = 0.39), age (r = 0.32, p = 0.10), or BMI (r = 0.31, p = 0.12) in the THA group. There are a few reasons why you might need to avoid MRI and … All methods were approved by the local institutional review board and the informed consent of subjects was obtained before enrollment in the study. ?associated lesions was fluid signal intensity with a thin (< 5 mm) intermediate-signal-intensity pseudocapsule (three cases) or Other, representing fluid signal intensity with a thickened intermediate-signal-intensity pseudocapsule (five cases). Secondary complications such as neurovascular compression due to an acute fracture of the numbers! Is limited in its ability to detect deep fluid collections may correlate to sex p., edema was an uncommon finding, particularly when a posterior approach used! Hip resurfacings in 30 patients ( 11 men, 13 ] was acquired orthopedic surgery implants... 1.5-T scanners ( 450 or HDx, GE Healthcare mixed fluid signal intensity ( arrows... 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